IM-23 FAMILY MO HEALTHNET (MAGI) MANUAL UPDATE TO EXCLUDE INCOME FOR CERTAIN TAX DEPENDENTS

FROM: KIM EVANS, DIRECTOR

SUBJECT: FAMILY MO HEALTHNET (MAGI) MANUAL UPDATE TO EXCLUDE INCOME FOR CERTAIN TAX DEPENDENTS

MANUAL REVISION #
1805.030.20.10

 

DISCUSSION:

MAGI Manual section 1805.030.20.10 Income Excluded Under MAGI is updated to reflect policy changes with Child Tax Dependent income and Qualifying Relative Dependent income. These two income types, based on IRS threshold rules for the current tax year, are excluded from the MAGI household.

This manual section in conjunction with IRS Publication 501 for the current tax year should be used to determine Child Tax Dependent and Qualifying Relative Dependent thresholds.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/kl

IM-22 MO HEALTHNET (MHN) POLICY UPDATES FOR CONTINUOUS ELIGIBILITY FOR CHILDREN (CEC)

FROM: KIM EVANS, DIRECTOR

SUBJECT: MO HEALTHNET (MHN) POLICY UPDATES FOR CONTINUOUS ELIGIBILITY FOR CHILDREN (CEC)

NON-MAGI MANUAL REVISION #

0405.000.00 0840.000.00
0430.010.00 0840.010.00
0805.000.00 0840.015.00
0805.020.00 0840.020.00
0810.010.00 0855.000.00
0810.010.05 0855.005.45
0815.030.20 1305.000.00
0815.070.00 1320.000.00
0825.000.00 1320.005.00
0825.010.00 1320.010.00
0825.040.00  

MAGI MANUAL REVISION #

1805.070.00 1840.025.05
1805.000.05 1840.025.10
1805.005.00 1840.030.15
1810.030.10 1885.000.00
1840.020.00 1885.010.00
1840.020.05 1885.015.00
1840.020.10 1885.020.00
1840.020.15 1885.035.00
1840.020.20 1885.040.00
1840.025.00  

 

DISCUSSION:

CEC was introduced in the 2023 Memorandum, IM-104 Continuous Eligibility for Children. The Centers for Medicare and Medicaid Services (CMS) has approved Missouri’s State Plan Amendment and MHN policy has been updated.

The following section was added to the Family MO HealthNet (MAGI) Manual:

The remaining MHN manual sections listed above are updated to reflect CEC policy.

Note: CEC does not apply to the Non-MAGI Blind Pension (BP) or the Supplemental Nursing Care (SNC) programs.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/vh

IM-21 UPDATED PROCEDURES FOR CONDUCTING INTERNAL IRS FIELD OFFICE INSPECTIONS

FROM: KIM EVANS, DIRECTOR

SUBJECT: UPDATED PROCEDURES FOR CONDUCTING INTERNAL IRS FIELD OFFICE INSPECTIONS

 

DISCUSSION:

There are new procedures for handling internal inspections of field offices and the handling of Federal Tax Information (FTI).

Field offices are required to submit the Internal Inspection Report/Field Office to Central Office annually. This process is now an electronic submission. Office managers will complete the electronic Internal Inspections Report for each field office at the following link: IRS Safeguards Internal Inspection Report Field Office.

Once the report is completed, signed and submitted it will be sent to the Divisional Privacy/Security Officer for approval and stored electronically. Office managers/designees retain a copy of the report in their office for seven years. All reports are available electronically. This report is used to monitor how the office handles FTI and must be received in Central Office by June 30th of each year.

Previous memo IM-53 from 2021 is now obsolete.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/nw

IM-19 RESTARTING CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) PREMIUMS, MO HEALTHNET SPEND DOWN (MHSD) PAYMENTS, AND TICKET TO WORK HEALTH ASSURANCE (TWHA) PREMIUM PAYMENTS; CONTINUOUS ELIGIBILITY FOR CHILDREN

FROM: KIM EVANS, DIRECTOR

SUBJECT: RESTARTING CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) PREMIUMS, MO HEALTHNET SPEND DOWN (MHSD) PAYMENTS, AND TICKET TO WORK HEALTH ASSURANCE (TWHA) PREMIUM PAYMENTS; CONTINUOUS ELIGIBILITY FOR CHILDREN

 

DISCUSSION:

In May, 2024, the “unwinding” period, as a result of the Public Health Emergency (PHE), will be over, and normal operations will resume.

This means that beginning June 1, 2024, all participants who are eligible for Ticket to Work Health Assurance in the “premium group”, or Children’s Health Insurance Program in the “premium group”, or MO HealthNet Spend Down will have to pay their premium or pay/meet their spend down before their MO HealthNet (MHN) services are covered. Letters will be mailed in March to notify participants of this policy.

This means that participants will need to pay their June invoice in May to have coverage on June 1, 2024. They must pay their TWHA or CHIP premium each month after that for coverage to continue. If they are in the Spend Down program, they must pay/meet their spend down for any month after May 2024 for which they would like MO HealthNet coverage.

This does not change the amount of their premium or spend down. Participants can pay their premium or spend down online by creating an account at memberportal.mymohealthportal.com.

Between now and June 1, 2024, until a participant’s annual renewal is completed, MHD will continue to provide coverage as it did during the PHE. If, after their annual renewal, a participant moves to a category that requires a premium or Spend Down payment, their coverage will also continue, regardless of payment, until May 31, 2024. Children covered through the CHIP program will also have their coverage provided until May 31, 2024, regardless of payment. After May 31, 2024, children moving from Medicaid for Children to CHIP must pay the first invoice before they receive continuous coverage.

*Beginning January 1, 2024, Continuous Eligibility for Children has begun. This means children eligible for MO HealthNet will have continuous eligibility for 12 months, even if their family circumstances change, such as an increase in income. For children in the CHIP Premium program, payment of the first month’s CHIP premium will be required before an eligible child can be enrolled in CHIP, but further non-payment of CHIP premiums, after the first month’s premium is paid, will not terminate a child’s CHIP eligibility for the remaining duration of the 12-month period.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/

IM-18 INTRODUCING THE NON-MAGI APPLICATION LETTER

FROM: KIM EVANS, DIRECTOR

SUBJECT: INTRODUCING THE NON-MAGI APPLICATION LETTER

FORM REVISION #
IM-2NMA

 

DISCUSSION:

A new letter, Non-MAGI Application Letter (IM-2NMA) was created to help Family Support Division (FSD) staff.

The IM-2NMA will be mailed with an Aged, Blind, and Disabled Supplement (IM-1ABDS) and/or a Medical Review Team Packet (IM-61MRT). These forms will be mailed to participants who completed a MO HealthNet application and were approved for a MAGI program – Adult Expansion Group or any of the Family MO HealthNet programs, but indicated that they are disabled or blind.

The letter informs the participant that since they indicated that they are disabled or blind on the application and may be eligible for Non-MAGI programs including:

  • MO HealthNet for the Aged, Blind, and Disabled Non-Spend Down
  • MO HealthNet for the Aged, Blind, and Disabled Spend Down
  • Ticket to Work Health Assurance
  • Nursing Facility (Vendor) Coverage

FSD will explore coverage for these programs, but additional information is needed. If the participant wishes to explore Non-MAGI benefits, then the enclosed IM-1ABDS and/or IM-61MRT must be completed and returned.

If the participant does not want FSD to explore Non-MAGI programs, no action is needed and any benefits already approved will not be affected.

The IM-2NMA is available for FSD staff to access in the internal forms manual.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Updated processes will be provided to staff in a separate email memorandum.

 

 

 

KE/cj

IM-17 REVISION TO APPLICATION REQUEST (IM-1REQ) LETTER FOR FAMILY SUPPORT DIVISION (FSD) APPLICATIONS

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISION TO APPLICATION REQUEST (IM-1REQ) LETTER FOR FAMILY SUPPORT DIVISION (FSD) APPLICATIONS

FORM REVISION #
IM-1REQ

 

DISCUSSION:

The Application Request (IM-1REQ) form has been updated and now includes information for applications mailed to participants when an obsolete application was submitted. The form was also updated to be used for Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance (TA) in addition to MO HealthNet (MHN). This letter will continue to be used when a participant requests a paper application be mailed to them.

Older revisions of applications may be determined obsolete when there are significant revisions. The FSD Memorandum announcing the revision(s) will provide details about whether older versions of the applications are obsolete and provide information about the grace period for accepting obsolete forms.

FSD cannot accept obsolete applications to request benefits after the defined grace period. Applications that have been revised and obsoleted recently include:

  • Application for Healthcare & Help Paying Costs (IM-1SSL) was revised and has a revision date of 9/2023. The grace period for accepting obsolete forms ended 12/31/23.
  • Application for Temporary Assistance (IM-1TA) was revised and has a revision date of 2/2024. The grace period for accepting obsolete forms will end 5/31/24.

Note: The Application for Supplemental Nutrition Assistance Program (SNAP) was revised in 9/2023, but older versions were NOT OBSOLETED as the changes were not significant.

When an obsolete application is received outside of the grace period, FSD staff will mail the IM-1REQ and a valid application to the participant. The letter provides information for the participant to complete an application online, by paper application, or by phone (for MO HealthNet only) to allow FSD to explore benefits. FSD staff will also return the obsolete application and any attached verification to the applicant.

The revised IM-1REQ is available for staff in the internal forms manual.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Discard old revisions and begin using the IM-1REQ (3/2024) revision immediately.
  • Additional guidance on obsolete applications is available to staff in the ECM Guide, Document Screening and Triage.

 

 

 

KE/cj

 

 

IM-16 2024 MO HEALTHNET OUTREACH PROJECT WITH DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION, LICENSED CHILDCARE PROVIDERS, AND FAMILY SUPPORT DIVISION

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2024 MO HEALTHNET OUTREACH PROJECT WITH DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION, LICENSED CHILDCARE PROVIDERS, AND FAMILY SUPPORT DIVISION

 

DISCUSSION:

Senate Bill 583 (2010) requires the Department of Social Services (DSS) to collaborate with the Department of Elementary and Secondary Education (DESE) and licensed childcare providers in an effort to reach the uninsured children of Missouri.

Each year, to comply with Senate Bill 583, the Family Support Division (FSD) provides DESE and licensed childcare providers with a flyer that informs parents how to apply for MO HealthNet (MHN) as follows:

  • Online at mydss.mo.gov/healthcare. Please send an email to Cole.MHNPolicy@dss.mo.gov with subject line “SCHOOL” or “FACILITY OUTREACH” to let us know to watch for your application. Include the parent’s name, child’s name, and child’s date of birth.
  • By telephone at 1-855-373-9994. When speaking with a representative please tell them this is a “School Application” or “Facility Outreach Application”.
  • Request an application from 1-855-FSD-INFO (1-855-373-4636). Please write “SCHOOL” or “FACILITY OUTREACH” at the top of the application.
  • Print an application online at https://dssmanuals.mo.gov/wp-content/uploads/2020/09/IM-1SSL-Fillable-Secured-6-24-21.pdf. Please write “SCHOOL” or “FACILITY OUTREACH” at the top of the application.

The attached flyers below will be distributed to schools and childcare facilities:

  • Two for DESE – one in English and one in Spanish
  • Two for Childcare Facilities – one in English and one in Spanish

FSD is required to track these applications for reporting. Each Resource Center and Customer Service Center is asked to document the receipt of these applications on the attached spreadsheets. School and Facility Outreach spreadsheets should be kept separate. Management should enter all information on the appropriate spreadsheet and submit monthly to Cole.MHNPolicy@dss.mo.gov.

 

NECESSARY ACTIONS:

  • Review this memorandum with appropriate staff.
  • Offices should begin tracking immediately and submitting documentation on the first week of each month.

 

ATTACHMENTS:

 

 

 

KE/kg

IM-15 INTRODUCING THE NATIONAL ACCURACY CLEARINGHOUSE (NAC) MATCHES FOR THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

FROM: KIM EVANS, DIRECTOR

SUBJECT: INTRODUCING THE NATIONAL ACCURACY CLEARINGHOUSE (NAC) MATCHES FOR THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

MANUAL REVISION #
1105.015.15
1125.025.00
1141.010.15

 

DISCUSSION:

The NAC is a system developed by the Food and Nutrition Service (FNS) to be used nationwide to compare data between states and prevent duplicate SNAP benefit issuances. It helps states ensure smooth transfers for people who may be moving between states.

The NAC must be searched any time someone applies for SNAP benefits, completes a SNAP recertification, or when a new person is added to the SNAP household. Before checking the NAC, a participant’s social security number, residency, and identity must be verified. If there is a match, the state must inform the household, take action, and inform the other state involved.

If a NAC match is received during a household’s certification period, staff must investigate the information according to SNAP unclear information policy within 10 days of receiving the match and inform the household before taking action. Once a determination has been made, staff must also share the outcome with the other state.

Note: This is a new program from FNS, not all states are currently sharing participant information with the NAC. If a participant reports receiving benefits in another state and a NAC match is not found, staff must still follow the existing procedures for verifying out of state benefits.

Do not disclose any location information to the household. System-generated notices will only communicate the change in household composition, and will not reveal the name of the state matched. If a participant questions a NAC match, staff may provide the following information:

  • Name of the matched individual, and
  • Dates of benefit issuances

This will protect individuals who may be in a vulnerable situation, such as someone staying in a battered women’s shelter or someone who shares information indicating they may be fleeing a dangerous situation.

NAC Web Portal:

All NAC queries for potential SNAP duplicate participation must be completed using the NAC web portal. The NAC web portal will be used to view information on NAC matches at application and to make necessary updates to inform the other state on the status of the match and what action(s) have been taken.

Note: A training will be made available through the Employee Learning Center (ELC) that will provide more details on how to sign up for access to the NAC portal as well as how to conduct searches and make updates.

In order to search the NAC, staff will need the participants’:

  • Name,
  • Date of Birth,
  • Social Security Number,
  • DCN, and
  • Search Reason.
    • Search Reasons include: New Application, New Household Member, Recertification or Other.

When a match is found when searching the NAC portal, the SNAP Participants Search Result section will appear on the bottom of the screen. Clicking on the Match ID will bring up the Match Details screen with more information.

When staff get a new match during a certification, the match notification email will have a Match ID to look up case information. The match notification will indicate the other state, if the participant is a vulnerable individual, and the three most recent month’s benefits issued in the other state.

Note: It is possible to get multiple matches for a single individual; however, at this time, Missouri is one of the first states to join the NAC.

The NAC portal also has fields to update the initial action taken and the final disposition (outcome) on the case. Updating these fields informs the other state of what actions Missouri has taken to resolve the match.

Note: NAC matches on active cases will be tasked in Current. Staff receiving a NAC match Current task will need to login to the NAC portal to review and update the match as necessary.

System Updates:

As of March 18, 2024, the eligibility system was updated with the following:

  • “NAC Y/N” field added to Received Out of State (RECOUTST/FMMW).
  • Two NAC-related verification codes were added:
    • NA—NAC Match Not Verified (Active Case Only)
    • NM—NAC Match Result- Not Living in Missouri
  • A notice of match received (NOMR/FA-601) for NAC Matches.
  • A notice of adverse action (NOAA/FA-510) with NAC match language.

NAC match on Initial, Recertification and Add-A-Person applications:

  • If a NAC match is received for an initial, recertification, or add-a-person application:
    • Enter “Y” in the the “NAC Y/N” field,
    • Enter the date the last benefit was received as it appears on the NAC match in the “Last Recd” field, and
    • Leave the verification code blank in order to request verification from the participant.
      • The eligibility system automatically generates and sends the proper NOMR for the NAC match via an overnight batch process.
        • The NOMR gives the participant 10 days to respond to the match, advises what is needed to resolve the match, and warns what the consequences are for the SNAP case if the household fails to respond.
  • If the household fails to respond to the match, the application will reject.
  • If the participant provides the proper verification to prove their out of state SNAP case has closed, enter “HC” (Hard Copy) to approve the case.
  • If the participant confirms the NAC match, is not living in Missouri, and still intends to receive benefits in another state, resolve the match with the following actions:
    • Remove the “Y” from the “NAC Y/N” field and
    • Enter “NM” (NAC Match Result- Not living in Missouri).

NAC match during Certification Period:

The eligibility system automatically shares SNAP participant data with the NAC on a daily basis which is then matched with similar data from other states. Any resulting NAC match received outside of the application period should be treated according to SNAP unclear information policy.

  • If the NAC match is received during the certification period, the RECOUTST screen must be updated.
    • Enter “Y” in the “NAC Y/N” field,
    • Enter the date the last benefit was received as it appears on the NAC match in the “Last Recd” field, and
    • Enter “NA” (NAC Match Not Verified [Active Case Only]) in the “VER” field to generate a NOAA combined with the NAC notice language.
      • The combined NOAA gives the participant 10 days to respond to the match, advises what is needed to resolve the match, and warns what the consequences are for the SNAP case if the household fails to respond.
  • If the household does not respond to the notice, the matched participant will be removed from the SNAP case.
  • If the participant provides the proper verification to prove their out of state SNAP case has closed, enter verification code “HC” (Hard Copy) to approve the case.
  • If the participant confirms the matched individual is not living in Missouri, and is still intending to receive benefits in another state, resolve the match by removing the “Y” from the “NAC Y/N” field and entering “NM” (NAC Match Result- Not living in Missouri) in the “VER” field.

Note: Updates in the eligibility system or Current Tasking system will not automatically update the NAC portal. Once staff complete their system entries, staff must log in and update the NAC portal in order for the information to be communicated to the other state per FNS regulations.

Additional SNAP Manual Updates:

Sections 1105.015.15 Duplicate Participation and 1125.025.00 Steps to Process Expedited Eligible Applications of the SNAP manual were updated to reflect that a NAC match must be resolved prior to the issuance of expedited benefits.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

 

KE/tl

IM-14 2024 UPDATE OF POVERTY INCOME GUIDELINES FOR MAGI PROGRAMS

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2024 UPDATE OF POVERTY INCOME GUIDELINES FOR MAGI PROGRAMS

MANUAL REVISION #
1805.030.20.10
APPENDIX A
APPENDIX A (PE)
APPENDIX B
APPENDIX D
APPENDIX E
APPENDIX I

FORM REVISION #
IM-4PRM

 

DISCUSSION:

Effective April 1, 2024, the Federal Poverty Level (FPL) income guidelines increase for all MAGI programs, including Presumptive Eligibility (PE).

MAGI cases were adjusted on March 8, 2024 based on the new FPL income guidelines. Due to the Continuous Eligibility requirement during the Transition Period, cases that have not had an Annual Renewal in the last 12 months will not have coverage closed or reduced to a lower level of care.
Note: Changes in circumstance or applications processed prior to April 1, 2024 will need to be authorized before the FPL change can be viewed.

PREMIUM REFUNDS

Premiums paid for April coverage will be refunded to the participant if the FPL causes the case to:

  • become eligible as a non-premium case;
  • go from CHIP75 to CHIP74; or
  • go from CHIP74 to CHIP73.

The refund process will take approximately 8 weeks to complete.

MAGI MANUAL REVISION, PROGRAM DESCRIPTIONS, AND OTHER RESOURCES

MAGI Manual section 1805.030.20.10 Income Excluded Under MAGI has been updated to reflect an increase in the tax filer threshold for a child for earned income to $13,850 and unearned income to $1,250 based on the 2023 IRS Publication 501.

PRESUMPTIVE ELIGIBILITY

PE Manual Appendix A income standards are updated. These standards are effective from April 1, 2024 through March 31, 2025.

 

NECESSARY ACTION:

  • Use the new FPL income guidelines beginning April 1, 2024
  • Review this memorandum with appropriate staff.

 

 

 

KE/rc

IM-13 2024 FAMILY MO HEALTHNET (MAGI) COST OF LIVING ADJUSTMENT (COLA) FOR SSA/SSI INCOME

FROM: KIM EVANS, DIRECTOR

SUBJECT: 2024 FAMILY MO HEALTHNET (MAGI) COST OF LIVING ADJUSTMENT (COLA) FOR SSA/SSI INCOME

 

DISCUSSION:

Effective April 1, 2024, MAGI cases will be updated to reflect a 3.2% COLA for Social Security Administration (SSA) and Supplemental Security Income (SSI) participants.

Cases Adjusted

Cases that include income types Social Security Adult (disability or received off disabled/deceased spouse), Social Security Adult (retirement), Social Security Child (disability or received off disabled/deceased parent), and SSI are subject to an automatic increase of 3.2%. The eligibility system will end date the previous income and add a new piece of income evidence that reflects the adjusted income amount.

Cases That Did Not Adjust

Some cases will not adjust during COLA. These cases will require manual intervention from staff to add the increased income amounts. As cases are reviewed, check the income on each case to determine if the current income is entered. Update and verify income as required using established procedures.

Notices
For case updates made as a result of COLA, the eligibility system will finalize the decision(s) and send out the appropriate notices.

Note: Due to the Continuous Eligibility requirement during the Transition Period, no cases will have coverage closed or reduced to a lower level of care until an annual renewal has been completed.

 

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

 

KE/vh